Moral distress in rural veterinarians as an outcome of the Mycoplasma bovis incursion in southern New Zealand

ABSTRACT

Aims

To gain insight into the world of rural veterinarians during the Mycoplasma bovis incursion within southern Aotearoa New Zealand by exploring their experiences during the incursion, and to understand the consequences, positive and negative, of these experiences.

Methods

A qualitative social science research methodology, guided by the philosophical paradigm of pragmatism, was used to collect data from an information-rich sample (n = 6) of rural veterinarians from Otago and Southland. Interview and focus group techniques were used, both guided by a semi-structured interview guide. Veterinarians were asked a range of questions, including their role within the incursion; whether their involvement had any positive or negative impact for them; and their experience of conflicting demands. Analysis of the narrative data collected was guided by Braun and Clarke’s approach to reflexive thematic analysis.

Results and findings

All six participants approached agreed to participate. Analysis of the data provided an understanding of the trauma they experienced during the incursion. An overarching theme of psychological distress was underpinned by four sub-themes, with epistemic injustice and bearing witness the two sub-themes reported to be associated with the greatest experience of psychological distress. These, along with the other two identified stressors, led to the experience of moral distress, with moral residue and moral injury also experienced by some participants.

Conclusions

Eradication programmes for exotic diseases in production animals inevitably have an impact on rural veterinarians, in their role working closely with farmers. Potentially, these impacts could be positive, recognising and utilising veterinarians’ experience, skills and knowledge base. This study, however, illustrates the significant negative impacts for some rural veterinarians exposed to the recent M. bovis eradication programme in New Zealand, including experiences of moral distress and moral injury. Consequently, this eradication programme resulted in increased stress for study participants. There is a need to consider how the system addresses future exotic disease incursions to better incorporate and utilise the knowledge and skills of the expert workforce of rural veterinarians and to minimise the negative impacts on them.

Clinical relevance

To date, the experience of moral distress by rural veterinarians during exotic disease incursions has been under-reported globally and unexplored in New Zealand. The findings from this study contribute further insights to the existing limited literature and provide guidance on how to reduce the adverse experiences on rural veterinarians during future incursions.

Abbreviations

MPI: Ministry for Primary Industries; PITS: Perpetration-induced traumatic stress; PTSD: Post-traumatic stress disorder.

KEYWORDS:

• Moral distress
• moral residue
• epistemic injustice
• Mycoplasma bovis
• veterinarians

Acknowledgements

The authors wish to sincerely acknowledge the participants for the time taken to share their experiences, which for some brought to mind traumatic events that remained deeply impactful. Without their commitment this research would never have happened. We also acknowledge the Stakeholder Panel for their knowledge and expertise of all matters farming and rural, that contributed to the development of the project’s methodology, as well as their networking and linkages into the southern rural community and incursion response networks. Additionally, we wish to acknowledge the wisdom and guidance of the Governance Group, who facilitated our navigation through at times delicate discussions with the wider community connected with the research project. The funder was Lottery Health Research LHR-2019-102211. In acknowledging the Stakeholder Panel we note that while the project was not a co-design study, stakeholder panelists contributed to the study design, data collection methods, the questionnaire manual and the recruitment of participants from the sector they represented. This does not imply responsibility of stakeholders for data interpretation and the write-up. The agency for the study resided with the researchers. Sectors represented on the stakeholder panel and the associated representatives are named below or the organisation represented is stated. Farmers –Southland Lloyd and Kathy MacCallum, Broadlands and Green Meadows farms; Small businesses – Sheree Cary, CEO, Southland Chamber of Commerce; Southland and Otago Agribusinesses – Luke MacPherson, Area Manager, Agribusiness, Southland Rabobank; Southland and Otago Rural Organisations – Katrina Thomas, Dairy Women’s Network, Southland and Otago Veterinarians – Rebecca Morley, Veterinarian; two representatives from Ministry for Primary Industries. Members of the Governance Group: Professor Peter Crampton (Centre for Hauora Māori), Ian Handcock (Farmstrong/Founder Fit4farming; retired farmer), Dr Mike King (Bioethics, Otago University), Lisa Te Raki (Ngai Tahu; Kaiwhakaako – Hauora Māori/Teaching Fellow – Māori Health), John Maclachlan (Veterinarian advisor).